Graeme Clark Collection
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ItemA multiple-channel cochlear implant: evaluation using speech tracking( 1981)Two totally deaf patients who had received multiple-channel cochlear implants were tested using a speech "tracking" procedure in which they had to repeat verbatim passages of connected discourse. Their performance was assessed by calculating the tracking rate (words per minute) each session. Testing was carried out under two conditions - lipreading along and lipreading in conjunction with a multiple-channel cochlear implant and laboratory speech processor. Lipreading with the cochlear implant increased the tracking rates by a factor of four for one patient and by a factor of two for the other when compared with lipreading alone.
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ItemA multiple-channel cochlear implant: an evaluation using nonsense syllables( 1981)A study using nonsense syllables has shown that a multiple-channel cochlear implant with speech processor is effective in providing information about, voicing and manner and to a lesser extent place distinctions. These distinctions supplement lipreading cues. Furthermore, the average percentage improvements in overall identification scores for multiple-channel electrical stimulation and lipreading compared to lipreading alone were 71% for a laboratory-based speech processor and 122 % for a wearable unit.
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ItemA multiple-channel cochlear implant: an evaluation using an open-set word test( 1981)Multiple-channel electrical stimulation of the hearing nerve in conjunction with speech reading has helped two post-lingually deaf patients with total hearing losses understand running speech in every day situations. This has been confirmed using open-set phonetically balanced word tests, where the patients achieved 60% and 40% scores with isolated-words and 80% and 73% for phonemes-in-isolated words. The tests also showed that the cochlear implant improved word recognition by a factor of four in one patient and two in another compared with speechreading alone. The speech processor used extracted the voicing frequency and energy and the frequency and energy of the dominant spectral peak in the mid-frequency range. The parameters for voicing determined the rate of stimulation for all electrodes, and the parameters for the dominant spectral peak in the midfrequency range determined the site of electrode stimulation and current level.
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ItemA multiple-channel cochlear implant. An evaluation using closed-set spondaic words(Cambridge University Press, 1981)Two post-lingually deaf patients with total hearing losses have had help in communicating, using a multiple-channel cochlear implant(Tong et al., in press; Tong and Clark, 1980). Single-channel implants have also been shown to be of value (House et al., 1976; Fourcin et al., 1979). As the multiple-channel device, however, requires an intra-cochlear electrode array it was considered worthwhile comparing the closed-set spondaic word test results obtained from our patients with those from intra-cochlear single-channel implants (Bilger et al., 1977). Using the multiple-channel device speech was processed by extracting the voicing frequency and energy, and the frequency and energy of the dominant spectral peak in the mid-frequency range. The parameters for voicing determined the rate of stimulation for all electrodes, and the parameters for the dominant spectral peak in the mid-frequency range determined the site of electrode stimulation and current level. On the other hand, with the single-channel implant (House et al., 1976) the speech wave amplitude modulated a 16 kHz carrier frequency, and this in tum stimulated the auditory nerve.
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ItemA multiple-channel cochlear implant: an evaluation using open-set CID sentences( 1981)A multiple-channel cochlear implant and speech processor have been used in two postlingually deaf adult patients with a total hearing loss, to enable them to perceive varying degrees of running speech. The results have been confirmed with open-set CID everyday sentence tests. Using the implant alone, the patients obtained 8% and 14% scores with pre-recorded material, and 34% and 36% scores for "live" presentations. This was equivalent to the perception of 35% of connected discourse. When the implant was used in conjunction with lipreading, improvements of 188% and 386% were obtained over lipreading alone, and the scores were 68% and 98% which were equivalent to the perception of 60% and 95% of connected discourse.
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ItemMultiple-electrode cochlear implant for profound or total hearing loss: a review( 1981)Patients who have developed a profound or total hearing loss cannot receive help with a conventional hearing aid. A promising way of restoring usable hearing and helping them communicate, however, is by electrical stimulation of residual auditory nerve fibres. Recently, single electrodes have been used to globally stimulate the auditory nerve, and patients have been helped in distinguishing voiced from unvoiced speech sounds, and in hearing the rhythm and intonation of speech. However, it is generally agreed that, if more speech information is to be conveyed to the patient, a multiple electrode system which selectively stimulates small groups of auditory nerve fibres will be required.
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ItemCurrent distribution measurements within the human cochlea( 1981)The magnitudes of tile currents returned through each ground electrode line of a multiple-electrode cochlear implant array were determined during surgical implantations on two patients. These were often found to be distributed widely to points far from the stimulus electrode site. Further measurements made in in vitro solutions demonstrated that the distributions were due largely to the ground electrode interface impedances being significantly larger than the fluid-path impedances, and demonstrated that distributions could be changed by modification of the ground electrode interface impedances.
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ItemPsychophysical and speech perception studies on two multiple-channel cochlear implant patients(Cambridge University Press, 1980)Preliminary studies on our first patient with a multiple channel cochlear implant (Tong et al., 1979) showed that he was able to associate the hearing sensations produced by electrical stimulation of residual auditory nerve fibres with different vowel (spectral) colours. The frequencies characterizing the vowel colours produced by stimulation at single scala tympani electrodes were, in general, closely related to the tonotopical organization of the� cochlea. Furthermore, results from these studies indicated that the pitch produced by single-electrode stimulation increased with pulse rate, and that the loudness increased with current level.
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ItemSpeech processing for a multiple-electrode cochlear implant hearing prosthesis( 1980)Abstract not available due to copyright.
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ItemA protocol for the prevention of infection in cochlear implant surgery(Cambridge University Press, 1980)The reduction of infection to an absolute minimum is a very desirable goal in any form of surgery. It is especially important with a cochlear implant operation as infection in the labyrinth can lead to degeneration of the auditory nerve fibres it is hoped to stimulate electrically (Clark et al, 1975). Furthermore, as the implantation of foreign materials increases the risk of infection, as the operation can last 6-7 hours (Altemeier et al., 1976), and as the operators are in very close proximity to the implant site, more stringent measures for the prevention of infection need to be adopted than with other forms of otological surgery. For these reasons a protocol has been developed for preventing infection in our cochlear implant surgery. This is an overall approach to the prevention of infection and involves pre-operative measures, an operating theatre routine, the use of horizontal laminar flow filter units, correct surgical technique and the use of systemic and local antibiotics.